DR. RICHARD IRA ELLENBOGEN (NPI# 1093804619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093804619 |
| Entity Type | Individual |
| Full Name | DR. RICHARD IRA ELLENBOGEN |
| Credential | DO |
| Practice Address |
4000 Highland Road #120 Waterford MI 48328 |
| Practice Telephone | 2486822109 |
| Practice Fax Number | 2486824769 |
| Mailing Telephone | 2486822109 |
| Mailing Fax Number | 2486824769 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 5101006200 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447472733 | Richard Ellenbogen | Plastic Surgery | 2101 Highland Ave, Unit B, Manhattan Beach, CA 90266 | 2007-05-03 |
| 1679659478 | Richard G Ellenbogen | Neurological Surgery | Harborview Medical Center, Pbs Building 401 Broadway, Seattle, WA 98122 | 2006-10-27 |
| Street Address |
4000 HIGHLAND ROAD #120 |
| City | WATERFORD |
| State | MI |
| Zip Code | 48328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477184125 | Lillian Atty | Pharmacist | 1484 Rivona Dr, Waterford, MI 48328 | 2020-01-31 |
| 1437631850 | Rana Ismail | Pharmacist | 3273 West Huron St, Waterford, MI 48328 | 2018-09-01 |
| 1588181978 | India Dunlap | Social Worker | 279 Summit Dr., Waterford, MI 48328 | 2017-08-25 |
| 1689191280 | Sydney Strandberg | Social Worker | 1145 Parkway, Waterford, MI 48328 | 2017-08-24 |
| 1467982074 | Briana Greenlee | Dietitian, Registered | 3819 Faber Terrace, Waterford, MI 48328 | 2017-06-15 |
| 1922537364 | Lourdes Alzheimer's Special Care | Custodial Care Facility | 2400 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1013446459 | Lourdes Assisted Living | Assisted Living Facility | 2450 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1588019053 | Legacy Dermatology Group PC | Dermatology | 1392 S Cass Lake Rd, Waterford, MI 48328 | 2016-05-03 |
| 1932567989 | Devenia Denise Clayter | Counselor | 255 Summit Dr, Waterford, MI 48328 | 2016-02-05 |
| 1922409739 | Stacey Diggs | Counselor | 250 Elizabeth Lake Road, Biomed Behavorial Healthcare, Waterford, MI 48328 | 2014-09-11 |
| Find all providers in zip 48328 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346548302 | Harvey Lee Raimi | Obstetrics & Gynecology | 950 N Cass Lake Rd Ste 112, Waterford, MI 48328-2370 | 2011-03-01 |
| 1740390053 | Keith Fortier | Obstetrics & Gynecology | 594 Copenhagen Rd, Waterford, VT 05819-9055 | 2006-08-30 |
| 1396787586 | Reda A Khalifa | Obstetrics & Gynecology | 3675 Highland Rd, Suite 112, Waterford, MI 48328-2326 | 2006-06-12 |
| 1942241633 | Michael Nicholson | Obstetrics & Gynecology | 5220 Highland Rd Ste 230, Waterford, MI 48327-1973 | 2006-06-10 |
| 1396707048 | Leonard Gordon Dorey | Obstetrics & Gynecology | 25 Pleasant Lake Dr, Waterford, MI 48327-3765 | 2006-04-06 |
| 1316919681 | Briana M Williams | Obstetrics & Gynecology | 818 Forrest Lane, Waterford, WI 53185-4577 | 2006-02-02 |
| 1417262387 | Cara Elizabeth Smith | Obstetrics & Gynecology | 5220 Highland Rd Ste 230, Waterford, MI 48327-1973 | 2010-08-16 |
| 1295881373 | Michael R Nicholson Md Pllc | Obstetrics & Gynecology | 5220 Highland Rd, Suite 230, Waterford, MI 48327-1975 | 2007-01-25 |
| 1912014416 | Stacy Ann Jenkins | Obstetrics & Gynecology | 5220 Highland Rd, Suite 230, Waterford, MI 48327-1913 | 2006-08-23 |
| 1578678140 | Dr Khalifa Reda Pllc | Obstetrics & Gynecology | 950 N Cass Lake Rd, Suite 112, Waterford, MI 48328-2370 | 2006-08-21 |
| Find all providers in WATERFORD | ||||
Please comment or provide details below to improve the information on DR. RICHARD IRA ELLENBOGEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.